Building wellness into a Cancer Centre

Paul Mitchell Olivia-Newton John Cancer and

Wellness Centre, Melbourne

Where did we start from? • Major public tertiary referral health service in Melbourne

• 980 beds, across 3 hospitals, including statewide services

• Large comprehensive cancer service – all components within the health service (greatest cancer WIES / bed-days in Victoria)

• Large clinical trials program

• Laboratory and translational research (Ludwig Institute, University of Melbourne)

• Co-located private hospital

The way we were....

•  Services fragmented, physically isolated, poor facilities

•  Staff scattered - separate administrative systems, minimal interaction

•  Services operated in silos

•  Cancer patients often experienced multiple treatment modalities under care of multiple units in different locations

•  Main cancer building from around 1910; rooms very small; narrow corridors; few single rooms; no en-suites; tiny day oncology

Heidelberg Repatriation Hospital Austin Hospital

Drivers for change

•  Need to improve cancer outcomes

•  Facilities not fit for purpose •  Patients •  Staff

•  Government policy – a new focus on cancer reform

•  Patient centred and personalised care

The outcome: ONJCWC •  World class 7-storey comprehensive

cancer care facility with increased clinical and research capacity

•  Co-located clinical multidisciplinary cancer services integrated with wellness and research

•  Focus on personalised care for patients and carers in all aspects of cancer journey

How it happened

•  Heidelberg Repatriation Hospital / Austin Hospital amalgamation – created a large cancer service

•  New Austin Health Clinical Building; co-location of Mercy Hospital for Women

•  Insufficient funding to co-locate cancer services

•  Opted for a fundraising strategy and a dedicated cancer facility

How it happened

•  New fundraising department with support of CEO and Board; Olivia NJ recruited

•  Senior cancer administrative and clinical staff heavily involved in fundraising and later in design

•  Funding from donations, State and Australian Government

•  Project Control Group chaired by Austin

•  Architects Darryl Jackson / MSJ

Building in wellness

•  Vision of what we want to achieve – but initially were not able to articulate the vision in terms of a building nor functionality

•  Worked very closely with architects •  Multiple refreshes done of the design •  Multiple staging options (dictated by blocks of funding) •  Refreshes of the schematic and detailed design means the cancer

staff learned on the job! •  Consumer input

Building in wellness: vision •  What is the experience when a new cancer patients walks

into the building?

•  Frightening and austere? Or warm and welcoming?

•  Would you choose to spend time in the environment?

•  Not a hospital yet not an hotel; more like home?

•  Spaces for people to interact throughout the building, inside and out. For the patient and their family / friends

•  Clinical requirements vs a supportive environment

Building in wellness: vision

•  What is the experience of the staff?

•  Get it right for the patient and it will be great for the staff!

•  A Cancer Centre and service to be proud of

Clinical and Research Medical Oncology and Clinical Haematology

•  64 beds •  25 chemo chairs •  23 room multidisciplinary outpatient clinic

Radiation Oncology •  3 linacs, 4 bunkers (linkage with Ballarat)

Palliative Care •  28 beds & Consultancy service

Cancer Clinical Trials (60+ staff)

Administration

Laboratory space – 2 floors

Clinical /lab collaboration space.

section

strategic organisation of clinical spaces

l day care l wellness centre l educating one another

third floor:

- --

Its curved facade appears as a “softer” building, where sunshades filter the light and take on a natural connection with the hillside. Inside, a connected curving journey (different to the adjacent laboratory corridors) links bedrooms, meeting areas and in particular, the ”look out” cantilevered lounges, sitting into the “curves”, to get a 180 degree view of the surrounding landscape.

Operable windows, accessible balconies, double glazed windows and sun-shading screens provide “patient autonomy” – allows patients the ability to control their own level of comfor t as they would in their own home - open a window, control their own lighting, step outside on the balcony etc.

Building is supported by intuitive way-finding and clear signage, organised around two strong circulation axes

The intersection of these culminates in the main entry space with direct links (nor th/south) connecting ONJ with Lance Townsend building and east/west connecting ONJ with Zeltner Hall.

connectivity:

Olivia wanted a cour tyard and a patient centre that was not “health depar tment” driven; and this was not hard for the architects to provide; it came in the form of Zeltner Hall, already an historic gathering space on the site; somewhat under used and readily available for conver ting into an educational and reception lounge for patients. . A Verandah overlooked a tiered garden, now rebuilt with running water, flower beds and shrubbery, leading the eye down to a lower sun terrace just outside the patient lounge...light, sun and fresh air ensure optimism.

Wellness Garden

One of the key drivers to its eventual form,

was considering the approach of the patients, visitors and carers to the facility – and of course the binding relationship with Austin Health – we understand the nature of cancer treatment means patients are “frequent flyers”

– this had significant impact on the overall de- sign of the building, in par ticular its necessity

to be engaging & welcoming and of appropriate scale.

The building was designed to maximise energy efficiency and minimise environmental impacts. Building systems were selected to maximise comfor t levels, such as the choice of passive chilled beams over air conditioning. Natural light has been harnessed and natural finishes, colours and textures used, to create a sense of bringing the outdoors inside.

alternative care settings

the goal sought by Olivia Newton john :

make a centre that had a “feel good spirit” about it. Olivia made caring and colours, sunlight and shade, tranquillity and softness, a critical balance, alongside the clinical setting of oncology treatments, radiology, operating theatres, laborator y testing

The Acute and Palliative Care wards are located on the upper levels, expressively designed to overlook the Valley to the south, with nor th sun derived from the cour tyard on the opposite side. As designers we wanted to distinguish the ONJ as “different” or “special”fitting in with the Heidelberg urban landscape to become an expressive distinctive form of the Austin Hospital.

l inpatients units connected to Ludwig Laborator y l staff exchange l transitional collaboration l research & clinical

upper plan:

An overall impression of openness is developed here to encourage staff to enlighten each other and to interact on a daily basis.

identity & meaning:

With thanks to…

• Slides: – Christine Scott. Manager Wellness Program – Alex Stephanou. Darryl Jackson Architects

paul.mitchell@austin.org.au